| NPI | 1972864148 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 867653) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS R867653) |
| Enumeration Date | 2012-06-05 |
| Last Update Date | 2019-10-03 |